MP22-18 THE VOLUMETRIC EVALUATION OF MULTI CENTRIC RESULTS OF ROBOT ASSISTED FLEXIBLE URETEROSCOPY

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You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2016MP22-18 THE VOLUMETRIC EVALUATION OF MULTI CENTRIC RESULTS OF ROBOT ASSISTED FLEXIBLE URETEROSCOPY Petrisor Geavlete, Jens Rassweiler, Jan Klein, Nida Zafer Tokatli, Olivier Traxer, AbdulQadir Al Zarooni, Yasser Farahat, and Remzi Saglam Petrisor GeavletePetrisor Geavlete More articles by this author , Jens RassweilerJens Rassweiler More articles by this author , Jan KleinJan Klein More articles by this author , Nida Zafer TokatliNida Zafer Tokatli More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , AbdulQadir Al ZarooniAbdulQadir Al Zarooni More articles by this author , Yasser FarahatYasser Farahat More articles by this author , and Remzi SaglamRemzi Saglam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.706AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Flexible ureterorenoscopy (fURS) has rapidly gained popularity in the treatment of renal stones during the last decade. With increasing indications and utilization efforts concentrate on increased maneuverability and durability of scopes while decreasing surgeons' fatigue and radiation exposure. We herein report our preliminary results of the new Remote robotic control system for fURS called Roboflex Avicenna (ELMED, Turkey) performed in 4 clinics in Ankara, Heilbronn, Bucharest, Umm Al Quwain. METHODS We treated 298 stones robotically and 28 stones manually as control group. All patients were suitable for fURS stone treatment. Routine preoperative tests and imaging were performed to all patients. Additionally volume (V) of each stone, calculated by a special software of CT or by approximation calculation by urologists. After insertion of a ureteral access sheath, Videoscope (FlexXC Storz, Germany) was introduced into the sheath manually. Then the scope was connected to the Roboflex in sterile condition and the time for this procedure had been recorded. Ergonomic chair of Roboflex can be adjusted in a comfortable position, according to the user. Deflection can be performed by manipulating the right handle similar to standart fURS. Precise deflection provided from the thumb wheel on the console. The rotation and forward and backward movement can be controlled by left handle. Fragments smaller than four fold of the laser fiber (means approx. 1 mm) were left for spontaneous passage. The fragmentation time recorded and the Fragmented Volume /per minute was calculated. At the end of the procedures, ureteral j stents were placed whenever indicated. RESULTS Mean Stone Volume was 1620 cubic mm (98-10600 cubic mm). Mean connection time to the Roboflex was 2 min. Stones were located in upper, middle and lower calices, and renal pelvis. Fragmentation Efficiency (FE) evaluated by fragmentation volume/per minute was 36 and 25 cubic mm /min for manual and robotic fURS respectively, but it increased to 33 cubic mm/min after 42 case. With some improvements of Roboflex FE was increased to 53 cubic mm/min. Stone-free status including fragments up to 2mm as controlled with x-ray on day 1 was achieved in all cases. We analyzed the CT controls after 1st and 3rd months. Fever not exceeding one day was seen in 2 patients. CONCLUSIONS Robot assisted fURS using Roboflex has been detected as a safe and efficient treatment method. It offers performing the procedure out of radiation exposure area while sitting. The operative results are also acceptable compared to the literature of manual fURS stone treatment. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e259-e260 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Petrisor Geavlete More articles by this author Jens Rassweiler More articles by this author Jan Klein More articles by this author Nida Zafer Tokatli More articles by this author Olivier Traxe